A longitudinal analysis of patient satisfaction with care and quality of life in ambulatory oncology based on the OUT-PATSAT35 questionnaire

Abstract

BackgroundIn the oncology setting, there has been increasing interest in evaluating treatment outcomes in terms of quality of life and patient satisfaction. The aim of our study was to investigate the determinants of patient satisfaction, especially the relationship between quality of life and satisfaction with care and their changes over time, in curative treatment of cancer outpatients.MethodsPatients undergoing ambulatory chemotherapy or radiotherapy in two centers in France were invited to complete the OUT-PATSAT35, at the beginning of treatment, at the end of treatment, and three months after treatment. This questionnaire evaluates patients’ perception of doctors and nurses, as well as other aspects of care organization and services. Additionally, for each patient, socio-demographic and clinical characteristics, and self-reported quality of life data (EORTC QLQ-C30) were collected.ResultsOf the 691 patients initially included, 561 answered the assessment at all three time points. By cross-sectional analysis, at the end of the treatment, patients who experienced a deterioration of their global health reported less satisfaction on most scales (p ≤ 0.001). Three months after treatment, the same patients had lower satisfaction scores only in the evaluation of doctors (p ≤ 0.002). Furthermore, longitudinal analysis showed a significant relationship between a deterioration in global health and a decrease in satisfaction with their doctor and, conversely, between an improvement in global health and an increase in satisfaction on the overall satisfaction scale. Global health at baseline was largely and significantly associated with all satisfaction scores measured at the following assessment time points (p < 0.0001). Younger age (<55 years), radiotherapy (versus chemotherapy) and head and neck cancer (versus other localizations) were clinical factors significantly associated with less satisfaction on most scales evaluating doctors.ConclusionsPre-treatment self-evaluated global health was found to be the major determinant of patient satisfaction with care. The subsequent deterioration of global health, during and after treatment, emphasized the decrease in satisfaction scores, mainly in the evaluation of doctors. Early initiatives aimed at improving the delivery of care in patients with poor health status should lead to improved perception of the quality of care received.

Cancer patients' perceptions of quality‐of‐care attributes—Associations with age, perceived health status, gender and education

“…This finding supports some earlier findings (Pini et al., ) but contradicts many others (e.g., Arraras et al., ; Ejaz et al., ; John et al., ; Wessels et al., ). Previous studies have suggested that perceived health status is associated with patients' assessments of quality care attributes (Brennan et al., ; Nguyen et al., ; Tremblay et al., ) and age (Browall et al., ; John et al., ). After the split of the data into the two age‐related subgroups, the subsequent analysis showed clear associations, within both groups, between patients' assessments of quality‐of‐care attributes and perceived health status.…”

“…In a third study, Nguyen et al. () found that self‐evaluated global health was the major determinant of patient satisfaction with care.…”

Determinants of patient satisfaction with cancer care delivered by the Danish healthcare system

“…30 Several studies have shown that cancer patients often are dissatisfied with the type and amount of information provided. 14, [16][17][18] In 2016, the Danish government launched several improvement initiatives aimed at improving the patient experience of cancer care. 6,7,9,11,12,15,29,31,32 In high-performing health care organizations, there is an increased focus on providing patient-centered care, including giving more consideration to the patients' needs and wishes and emphasizing shared-decision making.…”

“…2,3 Satisfied patients report higher quality of life and are more likely to comply with treatment and continue their use of medical services, which may lead to improved clinical outcome. [14][15][16][17][18] Other aspects that have been significantly associated with overall rating of care are the physical settings of the health care center, such as cleanliness and comfort, 8,17 as well as patient characteristics, such as age, 7,10,12,13,16,19,20 sex, 6,21,22 cancer diagnosis, 12,[22][23][24] education level, 10,12,20,22 self-perceived health status, 10,16,17 and metastasis. [6][7][8][9] Findings include aspects relating to the coordination of care, 10 information, 3,6,11,12 waiting times, 3,13 and interpersonal relationships between health care personnel and patients.…”

Patient satisfaction with treatment outcomes after surgery and/or radiotherapy for spinal metastases

“…Besides social functioning, more severe pretreatment neurological deficits of the arms or legs were also associated with dissatisfaction after surgery and/or radiotherapy. Neurological deficits have a debilitating effect on HRQOL and functional status; therefore, these patients may have had higher expectations of the functional outcomes and could be harder to satisfy …”